Sattu is a cooling high fiber food with low glycemic index and anti diabetic properties.

Sattu was the fast food of old times, cheaper and with enough calories to be termed as a full meal.

It also has adequate minerals and vitamins.

‘Sattu’ is a perfect blend of balanced nutrients and the best method of cooking – roasting. Shelf – life is increased.

One should not eat sattu without mixing with jaggery, ghee or curd.

One should not eat too much of sattu in the night and after having dinner.

As a ritual Sattu is offered by the husband to his wife at moon rise of "Badi –Teej". The wife neither eats nor drinks, even water for the whole day. At night, she breaks her fast by accepting a bite from the offered sweet. Next course is of fruits served on a leaf of ‘Aak’ (an holy bush of the desert), followed by a cup of ‘Phaddar’– a mock tail drink of beaten curd and sweetened milk. Lastly, a few drops of lime are added.

For adolescents around the world, report cards present a measure of their academic progress – and can point the way towards their futures. But how does the global community measure up in our efforts to give those young people the futures they deserve – and the tools and opportunities to make the most of their lives? As the 10th edition of UNICEF’s Progress for Children shows, this report card is mixed. For while we have made significant progress for millions of children over the last decades – reducing child mortality, increasing the number of children enrolled in primary school, expanding access to health care services – our efforts have left behind far too many adolescents between the ages of 10 and 19.

Some pointers from the Progress for Children report– Indian Context

In absolute numbers, India is home to more adolescents – around 243 million – than any other country. It is followed by China, with around 200 million adolescents nearly one third of adolescent girls in south Asia are married or in union.

Young people’s use of social media such as Facebook, Orkut in Brazil and India, has grown exponentially over the past few years.

Nearly 50 per cent of adolescent girls aged 15–19 in India are underweight, with a body mass index of less than 18.5.

Bangladesh, India and Nigeria alone account for one in every three of the world’s adolescent births. (The only industrialised country among the top 10 countries with the highest number of adolescent births is the United States).

In India, less than 30 per cent of mothers under 20 years old in the poorest households are assisted during delivery by a skilled birth attendant, compared to 90 per cent of young mothers in the richest households.

Young women in the poorest households are seven times more likely to give birth before age 18 than young women from the richest households in India.

World population needs to be stabilised quickly and high consumption in rich countries rapidly reduced to avoid "a downward spiral of economic and environmental ills", warns a major report from the Royal Society. Contraception must be offered to all women who want it and consumption cut to reduce inequality, says the study published on Thursday, which was chaired by Nobel prize–winning biologist Sir John Sulston. The assessment of humanity’s prospects in the next 100 years, which has taken 21 months to complete, argues strongly that to achieve long and healthy lives for all 9 billion people expected to be living in 2050, the twin issues of population and consumption must pushed to the top of political and economic agendas. Both issues have been largely ignored by politicians and played down by environment and development groups for 20 years, the report says. (Read the complete story at
http://www.guardian.co.uk/environment/2012/apr/26/earth–population–consumption-disasters?newsfeed=true, 26 April 2012)

Some patients may be concerned primarily with fertility, while others are more concerned about menstrual cycle regulation, hirsutism, or acne. PCOS should be treated because of the long–term health risks such as heart disease and endometrial cancer.

Weight loss: Obesity is commonly associated with PCOS. Fatty tissues produce excess estrogen, which in turn contributes to insufficient FSH secretion by the pituitary gland. Weight loss improves the hormonal condition of many PCOS patients. If you are overweight, ask your physician to recommend a weight control plan or clinic. Area hospitals and support groups are also helpful. Increasing physical activity is an important step in any weight reduction program.

Hormonal treatment: Hormonal treatment is frequently successful in temporarily correcting the problems associated with PCOS. If treatment is stopped, however, symptoms usually reappear. If you are not trying to conceive, birth control pills may be your best hormonal treatment. Birth control pills decrease ovarian hormone production and help reverse the effects of excessive androgen levels. However, birth control pills are not recommended if you smoke and are over age 35.

Ovulation induction: If fertility is your immediate goal, ovulation may be induced with clomiphene citrate. Clomiphene is simple to use, relatively inexpensive, and works well to induce ovulation in many patients. Clomiphene causes the pituitary gland to increase FSH secretion. Sometimes increasing the dosage or the length of treatment is necessary. PCOS patients who are insulin resistant may ovulate when treated with metformin, which increase the body’s sensitivity to insulin.

There was a good–natured millionaire in the town. Three beggars thought of approaching him for help. The first man went to the millionaire and said: "O Lord! I want five rupees. Please give me." The millionaire was taken aback at this man's impudence. "What! You demand five rupees from me as though I owe you the money! How dare you? How can I afford to give five rupees to a single beggar? Here, take these two rupees and get away," he said. The man went away with the two rupees.

The next beggar went to the millionaire and said: "Oh Lord! I have not taken a square meal for the past ten days. Please help me."

"How much do you want?" asked the millionaire. "Whatever you give me, Maharaj," replied the beggar.

"Here, take this ten rupee note. You can have some good food for at least three days." The beggar walked away with the ten rupee note.

The third beggar came. "Oh Lord, I have heard about your noble qualities. Therefore, I have come to see you. Men of such charitable disposition are the manifestations of God on earth," he said. "Please sit down," said the millionaire. "You appear to be tired. Please take this food," he said, and offered food to the beggar.

"Now please tell me what I can do for you."

"Oh Lord," replied the beggar. "I merely came to meet such a noble personage that you are. You have given me this rich food already. What more do I need from you? You have already shown extraordinary kindness towards me. May God bless you!"

But the millionaire, struck by the beggar’s spirit, begged of the beggar to remain with him, built a decent house for him in his own compound, and looked after him for the rest of his life.

God is like this good millionaire. Three classes of people approach Him, with three different desires and prayers. There is the greedy man full of vanity, full of arrogance, full of desires. He demands the objects of worldly enjoyment from God. Since this man, whatever be his vile desires, has had the good sense to approach God, He grants him some part of the desired objects (even these very soon pass away, just as the two rupees the first beggar got are spent before nightfall).

The other type of devotee prays to the Lord for relief from the sufferings of the world, but is better than the first one, in as much as he is ready to abide by His Will. To him the Lord grants full relief from suffering, and bestows on him much wealth and property.

The third type he merely prays to the Lord: "O Lord, Thou art Existence–Absolute, Knowledge–Absolute, Bliss–Absolute, etc., etc." What does he want? Nothing. But the Lord is highly pleased with his spirit of renunciation, of desirelessness and of self–surrender. Therefore, He makes him eat His own food, i.e., He grants this man Supreme Devotion to Himself. Over and above this, He makes the devotee to live in His own House For ever afterwards this devotee dwells in the Lord’s Abode as a Liberated Sage.

Situation: A patient had a strong family history of cancer. Dr. Bad: Just get regular check ups. Dr. Good: Take low dose aspirin. Lesson: A new observational analysis published online in the Lancet reports that long–term daily aspirin may prevent cancer deaths (Lancet 2011 Jan 1;377(9759):31–41).

Make Sure

Situation: A patient with acid peptic disease was denied any painkiller for his distressing illness. Reaction: Oh, my God! Why did you not give him nimesulide? Lesson: Make sure to prescribe nimesulide as it is safe in acid peptic disease.

Q. A 21–year–old boy was admitted with diagnosis of appendicular lump with right renal stone and was managed accordingly. During the period of hospitalization the fact, concealed earlier, came out that he was addicted to narcotics. He is to be discharged. Should the fact of narcotic addiction be mentioned in the discharge summary?

Ans.

Because he was addicted to narcotics, you might have had to give him higher doses of morphine, pethidine, etc. as part of treatment. He may later sue you for giving too much dose and hence making an addict out of him. Even otherwise, he may complain to the medical council that you gave doses more than necessary and against medical norms.

He may have to be hospitalised later in some other hospital where the lack of previous history of addiction in the discharge summary might induce the doctors towards a line of diagnosis and management that they would not have adopted had they known about such history. This may result in some damage to the patient for which the blame would ultimately fall on you.

If you mention it, what law are you contravening? None.

If you do not mention it, what legal action you are potentially inviting? Many, such as:

In previous columns we have learnt the ‘what, why, how’ of multidrug resistance, we shall now learn what can be done to prevent and control it. The principle of preventing MDROs is similar in the community and healthcare setup. Center for Disease Control (CDC) Atlanta, Georgia launched a ‘Campaign to Reduce Antimicrobial Resistance in Healthcare Settings’ with four concurrent approaches:

Infection prevention

Accurate and prompt diagnosis and treatment

Prudent use of antimicrobials

Prevention of transmission

Each one of these is very challenging to implement. The task is huge just because of sheer number of persons involved, practically whole of the hospital staff.

Laboratory confirmation of cases is done by swabs taken from nose, nasopharynx or throat preferably within 5 days of onset of illness. At this time RT–PCR technique is the authorized assay for confirmation of H1N1 virus infection.

Metabolic syndrome is defined as having three or more cardiovascular risk factors that occur together. These include elevated blood sugar, a larger waist, BMI over 30, high blood pressure, high LDL (bad cholesterol) levels and low HDL (good cholesterol) levels. Metabolic syndrome increases the risk for heart disease, stroke and diabetes. A Mediterranean diet, which emphasizes healthy fats, fruits and vegetables, and lean meats, has been shown to significantly reduce cardiovascular risk factors.

A new study comparing diet alone and the diet plus moderate to high intensity exercise found that the exercise group had greater improvements in some markers of quality of life such as physical function, vitality, general health, and perception of health. Exercise in addition to diet also resulted in greater physical fitness, better response to exercise stress, and greater weight loss. Given this research, adding moderate to high intensity exercise to a healthful diet can improve several health risk factors better than diet alone. People should be encouraged to seek out a safe setting for physical activity such as a health club, and to take advantage of the experienced trainers and group instructors there who are prepared to accommodate a variety of skill levels and motivate people to improved health.

Mind Teaser

Read this…………………

What percentage of your diet should fat make up?

A. About 10 percent of your daily calories.
B. About 20 percent of your daily calories.
C. About 30 percent of your daily calories.
D. About 40 percent of your daily calories.
E. There is no recommended amount of fat; you should strive to eat as little of it as possible.

Permanent and irreversible stoppage of respiration, circulation and brain function, the so called the ‘Tripod of life’

Generally the practicing doctor diagnoses death by auscultation; but, this can be difficult in cases of excessive fat, emphysema, apex beat below the rib, poorly beating heart and shallow diaphragmatic respiration. All these conditions dampen the conduction of heart sound with body wall.

Diagnosis of recent death is also very difficult whenever the death of the person has not been observed. When a doctor is called to certify a patient ‘as dead’ that is brought by ambulance, he must insist that the body be removed to a well lit room where he can carry out his examination.

Even though the condition is satisfactory, there can be error during examination. The signs of life can be detected by special methods like oscilloscope, ECG, and EEG etc.

It can never be assumed that attempted resuscitation is pointless. On the other hand, resuscitative measures should always be continued for half an hour.

There is segmentation of blood in retinal blood vessels in ophthalmoscopic examination. If still there is little doubt, the patient should be taken to intensive care unit for further investigation of heart and brain function.

Two or more prescription or over–the–counter drugs may interact negatively with each other and cause adverse drug reactions, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal, President, Heart Care Foundation of India. To reduce the risk of drug reactions, one must abide by the following guidelines:

Read labels carefully.

Understand the ingredients in each drug.

Understand any possible side effects the drugs may cause.

Before taking a drug, speak with the doctor or pharmacist if you do not understand the drug label.

Make sure the doctor is aware of all the drugs you are taking.

Do not mix pills.

Do not break capsules into any food or drink.

Do not take any medication with alcohol.

Do not take medication at the same time as vitamins or mineral supplements.

Readers Response

The Gujarat assembly passed a tough bill named "The Gujarat Medicare service persons and Medicare service Institutions (Prevention of Violence and Damage or Loss of property)" Bill last month, which makes any form of violence on medicare service personnel and damage of property of medicare service institutions a cognizable and nonbailable offense with imprisonment for a term which may extend to three years or with a fine which may extend to Rs. 50,000 or with both. The same type of law is applicable in Maharashtra. (Courtesy TOI 24.4.12) Why not all over India? Dr S K Verma, New Delhi.

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions